Sphenoid sinus mucocele presenting with isolated oculomotor nerve palsy

Isolated sphenoid sinus mucoceles are rare. Patients who have these lesions can present with several different symptoms and signs such as headache, nasal symptoms, and cranial nerves 2, 3, 4, and 6 palsies. Isolated oculomotor nerve palsy is not a common presenting symptom of sphenoid sinus mucocele. However, exclusion of sphenoid sinus mucocele should be made when the patient presents with isolated oculomotor nerve palsy. A case of sphenoid sinus mucocele with isolated oculomotor nerve palsy is presented with review of the literature. The oculomotor nerve function in this patient completely recovered after endoscopic sphenoidectomy.